Nutritional support for the pregnant adolescent.

Abstract

In 1990 the Weight Gain Subcommittee of the National Academy of Sciences of the US Institute of Medicine issued new recommendations formulated as weight gain ranges rather than as a specific weight gain number. Different ranges are delineated for normal weight underweight overweight and obese women. In addition attention is given to the pattern of weight gain over the course of the pregnancy. Although recommendations for adolescents were based on those for adult women adolescents are advised to gain on the high end of the weight gain range for their body mass index category. A method for distinguishing between growing and non-growing teens in a clinical setting has not been established. Most studies of pregnant adolescents conducted in the past 5-10 years have recorded average weight gains of 28-38 pounds--consistent with the current recommendations. A pattern of frequent small meals should result in an increased integrated blood glucose concentration without increased energy intake and weight gain and induce lower levels of insulin. High-carbohydrate low-fat diets may improve insulin sensitivity and reduce insulin requirements while enhancing maternal glucose utilization. Optimal adolescent pregnancy outcomes depend however on development of a more detailed individualized approach to maternal nutrition.